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Hematology & Anaphylaxis > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What is the mechanism of action for ASA?

A

Inactivates cyclooxygenase (COX) enzyme which decreases the production of prostaglandins in the tissue, blocking the pain receptors sensitivity and decreases inflammation. Due to the inactivation of COX, thromboxane A2 production is also inhibited, which is responsible for platelet aggregation

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2
Q

What are the indications for ASA?

A

Acute coronary syndrome

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3
Q

What are the contraindications of ASA? (3)

A

GI bleed
Asthmatics sensitive to ASA
Hypersensitivity

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4
Q

What is the dosage of ASA

A

160-325mg PO (chewed)

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5
Q

What are the side effects of ASA? (5)

A 
Indigestion
Gastric bleeding
Urticaria
Anaphylaxis
Nausea/vomiting
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6
Q

What are the precautions of ASA?

A

Patients on other platelet inhibitors

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7
Q

What is the classification of epinephrine? (2)

A

Sympathomimetic

Adrenergic

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8
Q

What is the mechanism of action of epinephrine? (7)

A

Stimulates alpha and beta receptors
Increases heart rate
Increases AV conduction
Increases force of myocardial contractility
Increases vasoconstriction (increases SVR)
Relaxes bronchial smooth muscle
Increases coronary and cerebral blood flow

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9
Q

What are the indications of epinephrine?

A

Anaphylaxis

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10
Q

What are the contraindications of epinephrine?

A

No contraindications

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11
Q

What is the adult dosage of epinephrine? (2)

A
  1. 3-0.5mg SQ/IM 1:1000 q 5-20 min

0. 1mg IV 1:10000

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12
Q

What is the pediatric dosage of epinephrine?

A

0.01mg/kg IM/SQ max 0.3 mg

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13
Q

What are the side effects of epinephrine? (7)

A 
Anxiety
Headache
HTN
Cardiac dysrhythmias
Tremors
Chest pain
Nausea/vomiting
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14
Q

What are the precautions of epinephrine? (4)

A

Cardiovascular disease
Elderly patients
Hypertension
Pregnancy

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15
Q

What is the classification of glucagon?

A

Pancreatic hormone

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16
Q

What is the mechanism of action of glucagon? (2)

A

Stimulates the release of glycogen from the liver for glycogenolysis
Smooth muscle relaxation

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17
Q

What are the indications of glucagon? (3)

A

Hypoglycemia
Beta blocker overdose
Esophageal foreign body

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18
Q

What are the contraindications of glucagon? (2)

A

Hypersensitivity

Pheochromocytoma

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19
Q

What is the adult dosage of glucagon for hypoglycemia?

A

1mg IM/SQ/IV

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20
Q

What is the pediatric dosage of glucagon for hypoglycemia?

A

0.5mg IM/IV/SQ (

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21
Q

What is the adult dosage of glucagon for a beta blocker overdose?

A

2-5mg IV

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22
Q

What is the pediatric dosage of glucagon for a beta blocker overdose?

A

0.5mg IM/IV/SQ (

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23
Q

What is the adult dosage of glucagon for an esophageal foreign body?

A

1mg IM/IV

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24
Q

What is the pediatric dosage of glucagon for esophageal foreign body?

A

0.5mg IM/IV/SQ (

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25
Q

What are the side effects of glucagon? (4)

A

Nausea/vomiting
Rebound hyperglycemia
Hypotension
Tachycardia

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26
Q

What are the precautions of glucagon? (2)

A

Effective only if there are sufficient stores of glycogen within the liver

Use with caution in patients with cardiovascular or renal disease

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27
Q

What is the classification of oral glucose?

A

Sugar

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28
Q

What is the mechanism of action of oral glucose? (2)

A

Provides glucose content for regular cell metabolism

Usually absorbed through mucus membranes

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29
Q

What are the indications of oral glucose?

A

BGL

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30
Q

What are the contraindications of oral glucose? (2)

A

Unable to maintain their own airway

Altered LOC

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31
Q

What is the dose of oral glucose?

A

1 tube orally/buccal PRN

32
Q

What are the side effects of oral glucose?

A

None

33
Q

What are the precautions of oral glucose?

A

None

34
Q

What is the classification of nitroglycerin? (3)

A

Anti-angina
Vascular smooth muscle relaxer
Vasodilator

35
Q

What is the mechanism of action of nitroglycerin? (2)

A

Relaxes vascular smooth muscle, there by dilating the veins and arterioles, causing blood pooling, which reduces preload

Reduces left ventricular systolic wall tension, which decreases afterload

36
Q

What are the indications of nitroglycerin? (2)

A

Possible ischemia due to: unstable angina or AMI

Pulmonary edema

37
Q

What are the contraindications of nitroglycerin? (6)

A 
Hypotension
Severe bradycardia
Severe tachycardia
Increase in ICP
Increase intracranial hemorrhage
Patients that have taken ED medications
38
Q

What is the dose of nitroglycerin (2)

A

0.4mg SL q 5 min

Infusion: 5.0 mcg/min titrate to effect increasing 5.0-10.0 mcg/min q 5-10 min

39
Q

What are the side effects of nitroglycerin? (8)

A 
Headaches
Hypotension
Bradycardia
Postural syncope
Weakness
Dizziness
Nausea/vomiting
Reflex tachycardia
40
Q

What are the precautions of nitroglycerin?

A

Administration to right ventricular infarct patients can result in severe hypotension

41
Q

What is the classification of salbutamol? (2)

A

Bronchodilator

Sympathomimetic B-2 agonist

42
Q

What is the mechanism of action of salbutamol?

A

Selective B-2 stimulation allows for smooth muscle relaxation of the bronchioles. Also has some B-1 affects causing an increase in HR

43
Q

What are the indications of salbutamol?

A

Bronchoconstriction

44
Q

What are the contraindications of salbutamol? (2)

A

Relative ischemic chest pain

Hypersensitivity

45
Q

What are the side effects of salbutamol? (5)

A 
Hypertension
Tachycardia
Muscle cramps
Dry nose and throat
Headache
46
Q

What are the precautions of salbutamol?

A

Pts with cardiac origin pulmonary edema

47
Q

What is the adult dose of salbutamol? (2)

A

5.0 mg NEB

4-6 puffs via MDI (1 puff q 30 sec)

48
Q

What is the pediatric dose of salbutamol? (2)

A

2.5mg NEB

2-3 puffs MDI (1 puff q 30 sec)

49
Q

What is the infant dose of salbutamol? (1)

A

1.25 mg NEB

50
Q

What is the classification of tetracaine?

A

Topical anesthetic

51
Q

What is the mechanism of action of tetracaine?

A

Topical ophthalmic anesthetic to allow for flushing of an eye by removing the blink reflex

52
Q

What is the indication of tetracaine?

A

To facilitate eye flushing

53
Q

What is the contraindications of tetracaine? (2)

A

Hypersensitivity to local anesthetics (caine family)

Possible penetrating eye injury

54
Q

What is the dose of tetracaine? (2)

A

2-3 drops in affected eye

Once treatment is done, moist gauze should be placed over eye until blink reflex returns

55
Q

What are the side effects of tetracaine?

A

May briefly increase irritation

56
Q

What are the precautions of tetracaine?

A

May cause blurred vision

57
Q

What is the classification of diphenhydramine? (2)

A

Antihistamine

Anticholinergic

58
Q

What is the mechanism of action of diphenhydramine? (4)

A

Competes with free histamines for biding and blocks H1 histamine receptors

Antagonizes the effects of histamine on Histamine (HA) receptors, leading to a reduction of the negative symptoms brought on by histamine

CNS depressant

Has antiemetic properties

59
Q

What is the indication of diphenhydramine?

A

Allergic and anaphylactic reactions involving respiratory difficulties, edema or severe itching

60
Q

What are the contraindications of diphenhydramine?

A

Hypersensitivity

61
Q

What are the side effects of diphenhydramine? (8)

A 
Drowsiness
Dizziness
Headaches
Excitable state
Thickening of bronchial secretions
Chest tightness
Reflex tachycardia
Hypotension
62
Q

What are the precautions of diphenhydramine? (2)

A

The sedative effects of diphenhydramine can be potentiated by the administration of CNS depressants, other antihistamines, narcotics and alcohol

Acute asthma as it may thicken secretions

63
Q

What is the adult dose of diphenhydramine?

A

25-50 mg IV/IM/IO

64
Q

What is the pediatric dose of diphenhydramine?

A

1-2mg/kg IV/IM/IO (max 50 mg)

65
Q

What is the classification of calcium chloride?

A

Electrolyte

66
Q

What is the mechanism of action of calcium chloride? (3)

A

Essential component for functional integrity of nervous and muscular system

Enhances automaticity

Positive inotrope

67
Q

What is the classification of magnesium sulfate? (4)

A

Electrolyte
Anticonvulsant (toxemia)
Antiarrhythmic (TDP, TCA OD)
Uterine relaxant

68
Q

What is the mechanism of action of magnesium sulfate? (3)

A

Reduces striated muscle contractions, causing vasodilation

Blocks peripheral neuromuscular transmission by reducing Ach released at the end-plate by motor nerve impulses

Minimizes recurrences of seizures in the toxic state

69
Q

What is the classification of potassium chloride?

A

Electrolyte

70
Q

What is the mechanism of action of potassium chloride?

A

Principle intracellular ion affecting muscular contraction and nervous system transmission

71
Q

What is the classification of sodium bicarbonate? (2)

A

Alkalinizing agent

Electrolyte

72
Q

What is the mechanism of action of sodium bicarbonate?

A

Reacts with H+ ions to form water and CO2

73
Q

What is the mechanism of action of pentaspan? (5)

A

Polysaccharides with water retaining properties and intravascular retention

The colloidal properties make it a useful volume expander

Intravascular infusion of pentaspan results in expansion of plasma in excess of the volume of pentaspan infused

Expansion exists for approx 18-24 hrs and is expected to improve hemodynamic status for 12-18 hours

70% of drug eliminated in 24 hours

74
Q

What is the classification of voluven?

A

Plasma volume expander

75
Q

What is the mechanism of action of voluven? (2)

A

Colloidal properties makes it a useful volume expander

Isovolemic exchange of blood maintains volume for at least 6 hours

76
Q

What is the classification of ASA? (3)

A

Antiplatelet
NSAID
Antipyretic

Hematology & Anaphylaxis (8 decks)

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